Family, Doctors, and Lawyers, Oh My!

Once again, it has been a big gap between my last posting and now. But, boy do I have some updates! You know, “You take the good, you take the bad…”

To start with, in general for everyone, we have had a big mess with our insurance. We did not discover the full scope of wrongdoing until this year, but apparently in January of 2011 my husband’s lovely employer switched us out of our Aetna plan, which was a MCN, and into a PPO. Naively, we thought that the MCN was just renamed across the board. Over the course of the year, however, we started noticing changes. It started with little things, like physical therapy appointments. We never really paid for them before (and believe me we get a lot of those services in our family) but suddenly we were being sent bills. We chalked it up to the company deciding to make us pay something out of pocket for a change. We were annoyed, but still thought it was in the realms of “normal”. The we started getting drastic bills for medical devices and supplies (Buddy’s brace, my ankle brace, Brian’s sleep apnea CPAP, etc.) It was around January of this year that my husband advised a co-worker that the “new” rules of the plan do not allow for free physical therapy. The co-worker argued about it. When my husband took out his card to compare, we realized the co-worker still had the same MCN we thought had “went away”. So did everyone else. Why were we the only ones switched?! When he complained to the insurance, they said we were changed in 2011. So he called benefits…and was informed we WERE changed, but they had no record of us doing anything or requesting it, which we didn’t. They outright admitted they have no clue how we were singled out, but it happened. Meaning, everything we have paid for a year has been BILLED AND PAID WRONG! First we were told that since we didn’t “notice the mistake” for over a year, we might only get it fixed now going forward. A talk to the union rep told us otherwise. So, first we got it retro’ed to January of 2012, and then finally to January of 2011.

Some good news: the lawyer called me today! It seems he is doing a last compilation of information for my disability trial!!! He said he expects to get a trial notice (which is sent one month before a trial) sometime during March or April. Hopefully we will see the end of the whole mess and finally get an answer, since I first put this in motion in 2009. Seriously, though, how do they expect people to wait?

As for me, medically, I have been to some of my regular doctors appointments. A trip to the oncologist reveals I am still in remission. (*Happy dance*) My numbers are good on my CA125, and physical exam was good, as well. That alone allows me to let out a big sigh of relief. Of course, the breath gets held in again in 6 months, but I can just enjoy these little things as they come. Also, a trip to the endocrinologist reveals my Grave’s Disease is also in remission! I am off the meds for that! Everything else? It is stable. I still have all the underlying conditions: Fibromyalgia, CFS, Asthma, Migraines. Also, I am still using the crutch (and also relying on a motor scooter for some day to day tasks) as my foot is not improved. I can hopefully get that physical therapy in now that the insurance issue is settled. (There was no way I was going to go while they would incorrectly bill me!)

Brian: His hand healed nicely. Weak at times, but otherwise nicely. He does, however, have to undergo surgery to remove that plate. Because the break was in a bad spot, the plate had to be in a bad place, as well. Keep him in your prayers!

Buddy: Well, the drama continues. At 16, the doctor feels that surgery is inevitable at some point. However, they want to hold off as soon as they can on the spinal fusion. He is young, and still growing. For now, he had the one injection already (see previous post) and will have 3 per year going forward. He is completely restricted in gym, pretty much for the rest of his high school career. He also cannot lift anything at all. He is in the process of getting special permission to have his backpack eliminated. Instead, he will leave his books in each class, and have his books digital when possible. (One class, which has a college level textbook, will allow him to keep an extra at home.) So we are looking at a tablet for him to make it easier. But, it is hard. He actually stayed home today, as he was in so much pain waking up this morning. Add that to the fact that I took him to the doctor because of enlarged lymph glands yesterday…and he is not a happy camper. (They have been there over a month. Ironically, the doctor is suspecting they are related to severe acne, which he slacks off on treating.)

Sierra: Some good news. Sierra’s migraine doctor gave her some meds which will help with the Fibromyalgia. Apparently, the primary care is just acting cautiously by waiting until she is 18. The dose she started on was mild, so not much relief yet. But she is returning soon, and we will hopefully be getting her an increase.

Kenzie: For once, something to report! We are in the process of getting her a diagnosis, as the school therapist feels she has the signs of ADD. So, we will see. But, I am very anti-ADD-medication, so I am concerned on where this will all lead.

And, finally, I happy to report that I have the taxes done early this year. 🙂  One less worry off my mind!

Hopefully more updates soon!

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